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Understanding Self-Harm

What is self-harm?

Self-harm is a behaviour that is done to deliberately harm oneself. Self-harm is more commonly used as a way of managing difficult emotions, by helping to regulate intense feelings.

The Addictive Model of Self-Harming Behaviour (Non-Suicidal and Suicidal) 

How do I talk about self-harm?

Talking about self-harm can feel hard and create difficult feelings and worries. Research tells us that talking about self-harm does not put the idea into their head. In fact, it creates a safe space for them to be open and honest about how they feel and provide them with a safe person to turn to.

To do this, you should:

  • Provide a safe and confidential space/environment.
  • Listen and explain the limits to confidentiality.
  • Reassure the child or young person that their feelings are important and valid, and it may help to talk about them.
  • Tell the young person how courageous they are to be talking about difficult thoughts and feelings.
  • Stay calm and always provide an empathic and non-judgemental approach. 
  • Use the https://www.richmond.gov.uk/portus/files/professionals-risk-assessment.pdf to help you understand the context of the behaviour and to help you make an informed decision about next steps.
  • Check in with them regularly to make sure the support offered is making a difference.

What questions could I ask?

  • How are things for you right now?
  • Can you say what’s bothering you? 
  • What might help you? 
  • What would you like to happen next?

How do I respond to self-harm?

If you have serious and immediate concerns regarding the safety or a child or young person due to self-harm or suicidal ideation, contact the emergency services on 999 or the Mental Health Trust 24/7 crisis line on 080 0028 800.

Refer to the Self-Harm and Suicide Prevention Pathway to help you and your colleagues to make decisions about the support required: Children and Young People’s Self-harm and Suicide Prevention Pathway.

It is important to ensure parent’s and carer’s are involved in this process unless there are safeguarding concerns relating to the young person’s family. 

As young people should be attending an educational setting on a regular basis, schools and colleges are also well placed to support anyone who is facing emotional distress.

Are they at risk of suicide?

While self-harm is relatively common in young people, suicide is rare. Although some people who self-harm may experience suicidal thoughts, this is often not the case. Suicides are uncommon in childhood and early adolescence, but risk increases in the late teens and continues to rise into early adulthood.

The following steps can help you find out if a child or young person is thinking about suicide. 

Ask directly.
Use the word suicide. ‘Are you thinking about suicide?’ Practice asking first if this helps. It may give you more confidence.

Stay calm.
This is important as the child or young person may be looking at how you react to decide how much they should tell you.

If you are unsure of how to start the conversation, contact the Papyrus helpline HOPELINEUK on 0800 068 4141. Papyrus’ specially trained advisers can talk you through what to say and how to support the child or young person during this conversation. 

Talking with a child or young person about suicide can be very difficult. If you need support following your conversation, Papyrus’ advisers are on hand to de-brief with you and help you to process what has been said and where to go next.

If the child or young person says that they have had, or are currently experiencing, suicidal thoughts, you should create a personalised plan to help keep them safe: Suicide Prevention Support and Safety Plan.

Additional resources 

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Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a common, lifelong neurodevelopmental disorder characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

Depending on the presentation, there are different subtypes of ADHD namely:

  1. Inattentive Subtype (previously known as ADD): 20-30%
  2. Hyperactive-Impulsive Subtype: 15%
  3. Combined Subtype: 50-75%

As an area of neuro-diversity, ADHD can co-exist with other areas of neurodiversity such as dysgraphia, developmental coordination disorder, and a large overlap with autism (25-40%). Individuals with ADHD can also present with depression and anxiety, possibly as a result of unmet needs and difficulty adjusting to environments that cater for neurotypical children.


ADHD and Executive Functioning

Executive Functions: Executive functions are cognitive processes that help us plan, focus attention, remember instructions, and manage multiple tasks. They are primarily located in the prefrontal regions of the frontal lobe and involve multiple connections to other brain regions.

Key Executive Functions Affected by ADHD:

  1. Working Memory: The ability to hold and manipulate information over short periods.
  2. Sustained Attention: The capacity to maintain focus on a task or activity over a prolonged period.
  3. Organization: The skill to arrange thoughts, materials, and tasks in a structured manner.
  4. Response Inhibition: The ability to control impulses and resist distractions.
  5. Emotional Control: The capacity to manage emotions and respond appropriately to situations.
  6. Time Management: The skill to plan and allocate time effectively.
  7. Planning and Prioritizing: The ability to set goals, plan steps to achieve them, and prioritize tasks.
  8. Task Initiation: The ability to begin tasks promptly and efficiently.
  9. Goal-Directed Persistence: The capacity to stay focused on a goal despite obstacles and distractions.

Impact of ADHD on Executive Functions:

People with ADHD often experience a delay in the development of executive functions, making them more likely to act based on short-term rather than long-term goals. ADHD can lead to impairments in one or more executive functions, affecting memory, planning, emotional regulation, and social skills.

Supporting children with their executive function skills, as well as the impact of the environment on their capacity to keep up with school life, is a key area of our EP role and a prerequisite for the child’s overall academic progress and emotional wellbeing.


7 x top tips for schools to consider are:

Learning Environment:
Minimise distractions, use visual aids, allow movement breaks, and provide a quiet space.

Teaching Strategies:
Provide clear instructions, break tasks into manageable chunks, use visual cues, and incorporate meaningful movement.

Emotion coaching:
Remain calm, connect before correcting, use redirection, avoid arguing, and provide feedback on the skills observed and what else the child needs to be doing. Be specific! 

Whole School Approach: 
Provide a structured environment, positive reinforcement, psychoeducation, and support for parents.

Interventions: 
Provide young people with a space to understand themselves and their emotions. Where you may need to support social skills, please consider the language used to ensure we are not asking individual students to mask or reject aspects of their identity. Supporting memory and executive functions through play and games may be an ideal way to support development in a non-threatening or tiring for children way. 

ADHD bodies may require additional sensory processing support such as mindfulness and body scans. It would be ideal to create a bank of regulatory strategies with the child so they feel part of the process and develop their capacity for self awareness and self-regulation. Adults need to model this by thinking out loud “the energy in your body tells me that perhaps we need to…”

Strengths-Based Understanding of ADHD:
It is important to recognise and celebrate strengths such as creativity, energy, enthusiasm, and resilience. Children with ADHD can present with hyper focus on areas they are interested in so utilising this to promote other skills may be an ideal way to turn their ADHD into a superpower! 

ADHD and Trauma:
We are mindful that childhood trauma and children being in a chronic high alert state can also create presentations very similar to ADHD. Many children with trauma end up receiving a diagnosis of ADHD and EPs are often involved in conversations with schools to support staff in considering appropriate and trauma informed ways to support children with hyperactivity, organisational difficulties and emotional regulation challenges.

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Support with Exam Anxiety

What is Exam Anxiety?

Exam anxiety is an intense feeling of stress or pressure related to taking exams. Children and young people who are experiencing exam anxiety may exhibit some of the following symptoms: 

Exam anxiety is common and a normal response to the stress of exams but too much anxiety can impact the ability of children and young people to learn and retain information, and interfere with studying and revision.  

Source: https://www.psychologytools.com/self-help/anxiety


Why do we experience Exam Anxiety?

Some common reasons why children and young people might feel exam anxiety include:

  • Fear of Failure: This may stem from high expectations, negative past experiences and/or concerns about the consequences of failing that lead to intense pressure to perform well. 
  • Not Feeling Prepared: This could be due to poor time management or ineffective study or revision techniques. 
  • High Stakes: Important exams such GCSEs and A-Levels can increase anxiety due to their significant impact (e.g. not getting the entry requirements for a specific course). 
  •  Lack of Confidence: This could include negative perceptions and self-doubt about their abilities and negative self-talk (e.g. “I’m going to fail.”)

How can we support Exam Anxiety?

Children and young people can find exams a lot to cope with, but there are ways that we can support them to improve their wellbeing during this time.


1. Foster a Supportive Environment: Create a classroom environment that encourages open discussion about exam anxiety and stress. Through this open discussion children or young people will feel able to seek help if needed and supported.

2. Encourage Positive Self-Talk:  Help students identify and challenge negative thoughts about their abilities and the exam outcome. Encourage them to rethink these negative thoughts these with positive affirmations and rational thoughts. This is known as ‘reframing’ thoughts. Examples of reframing thoughts include:

I’m so anxious in exams, my mind always goes blank” can be reframed to “I am confident that I can manage any difficulties that might occur during the exam

If I don’t get the highest grade on this exam I’m a failure” can be reframed to “The result of this exam does not define my abilities or worth

3. Listen and Normalise anxiety:  Listen to the child or young person about their concerns to validate their emotions. Reassure them that feeling anxious because of exams is common and can be a normal response to stress. This reassurance can help reduce feelings of isolation in someone experiencing anxiety.

4. Promote Healthy Habits: Educate the importance of regular sleep, healthy eating, and physical activity during revision and exam seasons. These factors can significantly impact children and young people’s ability to manage stress, improve general wellbeing and perform at their best during exams.

5. Model Calm Behaviour: As adults we can demonstrate calm and confident behaviour towards exams. The child or young person’s perceptions of a situation can be influenced by your attitudes and reactions therefore having a positive impact on how they view exams. Use positive language such as, “You have worked hard and are more than ready to take this exam”.

6. Promote Relaxation and Mindfulness Techniques: In order to help students manage their physical responses to anxiety, you can teach them: 

7. Manage Procrastination and Avoidance Behaviours. Exam anxiety often drives procrastination as a temporary relief but ends up promoting greater anxiety. Strategies such as breaking down revision into manageable chunks, prioritising tasks, encouraging progress checking and celebrating small successes can help. 

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Understanding the systems around a child

Child development does not take place in a vacuum, instead, the context around the child impacts their actions and development. Schools are uniquely placed to influence children’s development due to their key role in their lives and the time spent at school. 

One way of viewing child development is through the Bioecological Model of Human Development (Bronfenbrenner & Morris, 2007). This model considers the impact of social contexts, structural conditions and political factors on children’s school experiences and the role they play in mediating their development (Bronfenbrenner & Evans, 2000). It highlights the importance of the environmental factors around a child that influence their development from those closest to them (family, teachers) to more indirect factors (government education policies).

Bioecological Model of Human Development

The Bioecological Model is marked by four key aspects: process, person, context, and time (Tudge et al., 2022).

  • Process – this focuses on the interactions between people and their environment, which take place over time. Some examples that are relevant to school include CYP and staff relationships or interactions, staff training and teaching
  • Person – this relates to the individual child and further details are included in the diagram below.
  • Context – this describes four interrelated systems that mark the environments that influence development and are further explained below. 
  • Time – this relates to changes in the environment throughout the child’s lifetime, for instance, changing cultural attitudes, historical events, and life transitions like moving abroad.
Figure 1 – Diagram showing the person and context aspects of the Model

Cultural context

This relates to broader societal attitudes and ideologies, e.g., cultural norms, and societal views of education.

Greater environment 

This relates to aspects that indirectly influence the child’s development e.g., what is happening within the school more broadly, or in their parents’ workplace.

Interactions and connections

This layer considers the interactions that happen within the child’s immediate environment, e.g., relationships between parents and school, and relationships between the child and their teachers.

Immediate environment

This is the first layer around the child and relates to aspects that have direct contact with them and influence their day-to-day life, e.g., home life, school environment and peers. 

Child

This includes their individual characteristics, e.g., age, ethnicity or other features that affect how others view or treat them. Also, their psychological resources along with their skills, experiences, and individual motivations that influence their responses to situations.

How can the Bioecological Model be applied in school settings?

This Model is flexible and provides a way of thinking about how individual traits and surrounding environmental factors influence and interact with one another as part of an ongoing process of child development.

The example below shows how the Model has been applied in the case of a Year 6 boy who is experiencing literacy difficulties.

Figure 2 – Example of the Model applied to an individual child

References

Bronfenbrenner, U., & Morris, P.A. (2007). The bioecological model of human development. In W. Damon & R.M. Lerner (Eds.), Handbook of child psychology. Vol. 1: Theoretical models of human development (6th ed., pp. 793–828). John Wiley. 

Bronfenbrenner, U. and Evans, G. W. (2000), Developmental Science in the 21st Century: Emerging Questions, Theoretical Models, Research Designs and Empirical Findings. Social Development, 9(1), 115-125. https://doi.org/10.1111/1467-9507.00114

Tudge, J. R. H., Merçon-Vargas, E. A., Liang, Y., & Payir, A. (2022). The Importance of Urie Bronfenbrenner’s Bioecological Theory for Early Childhood Education. In L. E. Cohen & S. Waite-Stupiansky (Eds.), Theories of Early Childhood Education: Developmental, Behaviorist and Critical (2nd ed.). Routledge.

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Insights into creating an Attachment Aware School 

The article below discusses the benefits and impact on becoming an Attachment Aware school based on Amy’s doctoral research thesis titled: An Exploration of the Views and Experiences of Designated Teachers in Creating an Attachment Aware School. To view the thesis in more detail please click here:

An exploration of the views and experiences of Designated Teachers in helping to create an Attachment Aware School | BPS

What was your research about?

During the pandemic 5 primary schools in southwest London took part in a pilot project to become Attachment Aware schools.  The Designated Teachers (responsible for children who are looked after CLA) played a key role in facilitating the project. The Designated Teachers were all interviewed at the end of the year to reflect on their views and experiences. Key themes emerged from analysing the interviews (using Interpretative Phenomenological Analysis).

What is an Attachment Aware School?

An Attachment Aware school is a school that takes a relational approach to supporting its students. This type of school is often supported by Educational Psychologists and Virtual schools in order to create systemic changes to support children and young people who may have experienced trauma or disruptions to forming secure attachments, such as CLA. Many Local Authorities have some version of this approach although terminology used may vary such as Trauma informed Practice (TIP), Attachment Aware Schools (AAS) etc.

What motivated schools to become an Attachment Aware school?

  • A desire to support the needs of children in the school (the project took place at the start of the pandemic and so there was an increase in mental health needs).
  • It’s free, there was no cost to schools.
  • It fitted in with the ethos of the school and other relational approaches used.
  • A desire to learn evidence-based approaches. 

One of the Designated Teachers stated:

“The main thing for us was to…to help with any behaviour issues and to make sure that we’re approaching it in a way that dealt with the initial underlying problem rather than just firefighting…”

How did the Attachment Aware Schools approach develop within the schools? 

Schools worked over the year to develop systemic and environmental factors. Schools developed behaviour policies, transformed the environment (to create accessible calm spaces), provided staff with training based on trauma and attachment theory as well as developed restorative approaches to responding to behaviour.

What were some of the changes that occurred in the schools after becoming an Attachment Aware School?

The Designated Teachers reflected on physical/environmental and systemic changes that were occurred:  

  • The attitude of staff towards children, resulting in improved relationships and behaviour.
  • Changes in children’s interactions (with their peers) and staff,
  • Improved relationships between the schools and parents/carers
  • Nurturing and inclusive environment were created, such as calming spaces (that children could use to regulate their emotions)

Which children benefited from the Attachment Aware school approach?

Schools have a statutory duty of care to support CLA by the Designated Teacher and supported through the Virtual School. Although, a key aspect of Attachment Aware Schools is to support the needs of CLA the research found the scope of children who could benefit from such an approach was wide ranging.  The research found that children who were anxious, have special educational needs or who were described as shy also benefited from the approach.

Another Designated Teacher stated the wider benefits:

“I do think that Attachment Awareness helps because if children aren’t emotionally ok, they’re not gonna learn”.

Did the research identify any potential barriers?

Potential barriers identified through this research in implementing the approach ranged from:

  •  Training e.g. the time taken to train staff, embed the new approach and train staff due to staff turnover.
  • Some staff found that the approach was counter to how they may have been raised and so there was some cognitive dissonance between the relational based approach and the punitive approach that they were more familiar with. However, once staff saw the difference that the approach could make to children displaying challenging behaviour, they were then more likely to use the approach.

How does this research fit within similar research in this area?

Research in this area is growing and provides noteworthy evidence of wide-ranging improvements. Some larger scale studies have illustrated positive improvements:

Rose and Gilbert (2017) conducted a large-scale study involving 40 schools over 2 years. This research provided hard and soft indicators of improvements ranging from increases in academic performance, staff confidence and increase self-regulation of students. 

  • Academic improvements in reading, writing and Maths,
  • Increase in attendance,
  • Improvements in staff-wellbeing; in relation to an increase in staff confidence in responding to challenging behaviour and staff becoming more reflective in their practice.

Kelly (2020) involved 77 educational establishments (primary, secondary, specialist and Pupil Referral Units). Evaluation from the research suggests all participating schools had a positive impact by for example developing ethos change within the schools and more informed pedagogical practice to support Children who are Looked After and other vulnerable learners. 

Additionally, the Alex Timpson Attachment and Trauma Aware Programmes in Schools (2022) reviewed the impact of training from 305 schools across 26 Local Authorities.  Some of the findings highlighted, a reduction in the use of sanctions, a positive impact on students, and increase in staff awareness of how behaviour e.g. how behaviour displayed relates to the child communicating a need. 

How can I get my school involved in something similar?

  • Attachment Aware Schools are a whole school approach. It is important that everyone is on board with the aims of using such an approach. Raise awareness within the school and speak to the head teacher about potential benefits of using such an approach. 
  • Schools can contact their local Educational Psychology service or Virtual School for more information to find out how the approach is being delivered within their local area.
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Supporting children through bereavement 

Becoming withdrawn, having emotional outbursts, difficulties sleeping, feeling unwell and changes in appetite are all common responses after experiencing a bereavement. 

As adults, our natural response is to try and make things better for young people and take away these uncomfortable feelings. But grief is a natural part of life and it is important that young people are able to process the loss they have experienced with the support of the adults around them. 

So how can we support children through bereavement? 

1. Listen, empathise and allow space for children to ask questions – Listen to the child or young person and validate their emotions. Avoid trying to fix things or make things better. Remind the child or young person that it is normal and okay to feel sad or angry. 

2. Use clear language when talking about death – children often interpret information literally so using phrases such as ‘they are in a better place’ or ‘passed away’ can be confusing. Although it can feel difficult, research shows that it is helpful to use clear language such as ‘death’ and ‘died’. For younger children, we might explain that ‘their body stopped working’. 

3. Encourage the child or young person to talk about the person who has died – we sometimes avoid talking about the person who has died because it feels painful, but this can be a helpful way of processing the loss. Ask the child or young person questions about the person who has died e.g. ‘What was your favourite thing to do together? What is your favourite memory?’ 

4. Support the child or young person to continue engaging in important activities and connecting with others – maintaining a sense of routine and stability can be helpful during times of change and during a bereavement. Where possible, support the child or young person to continue engaging in activities they enjoy. Sometimes children or young people experience guilt when they have moments of feeling happy after a bereavement. Remind the child or young person that it is okay to feel happiness and enjoyment even though something sad has happened. 

5. Be sensitive and non-judgmental to differing cultural, religious and spiritual beliefs – ask children and young people what has been discussed at home and what their beliefs are. Explain that everybody has different beliefs about what happens after death and that there is no right or wrong. 

Developmental understanding of death

StageAge RangeConceptualisation
13 – 5Death is not a permanent condition. The dead are less alive – similar to being very sleepy, i.e. they can still breathe and eat.

The dead may wake up after a while. A dead person can come back to life.
25 – 9Death is final. The dead stay dead. Death is irreversible but not inevitable. There is the possibility of escaping from death if one is clever or lucky.

Some children at this stage of development picture death in the form of a person: sometimes an angel, a clown, shadowy death-man, or skeletal figure. Moving things are viewed as alive and non-moving as dead. Only bad people or people who have accidents die.
310+A more realistic, adult like view of death emerges. Death is not only final, but it is also inevitable, universal, and personal. Everybody dies, whether mouse or elephant, stranger or parent. No matter how good or clever or lucky. 

Helpful books for talking about loss:


Badger’s Parting Gifts
Susan Varley

Badger is so old that he knows he must soon die, so he does his best to prepare his friends. When he finally passes away, they are grief-stricken, but one by one they remember the special things he taught them during his life. By sharing their memories, they realise that although Badger is no longer with them physically, he lives on through his friends.

Lost in the Clouds
Tom Tinn-Disbury


Billy misses his mummy very much. She lives in the clouds. Some days the sun is shining and Mummy’s clouds are nowhere to be seen. Those are Billy’s favourite days. He and Daddy would play in the garden all day long, and Billy knows that Mummy is letting the sun shine for them. But not all days are like that. Sometimes Mummy’s clouds are dark, and Billy feels sad and alone.



Missing Mummy
Rebecca Cobb

Perfectly pitched text and evocative artwork explore the many emotions a bereaved child may experience, from anger to guilt and from sadness to bewilderment. And importantly, the book also focuses on the positive – the recognition that the child is still part of a family, and that his memories of his mother are to be treasured.



Ollie the Octopus
Dr Karen Treisman

In a magical underwater forest lived a colourful and loveable Octopus called Ollie, who loved swimming with his friends and spending time with his mum and dad, Orla and Orson the Octopuses.  Until one day, Orla started to get very sick. The doctors did everything they could to help her, but very sadly, Orla died.



The Invisible String
Patrice Karst

Does everybody have an Invisible String? How far does it reach? Does it ever go away? This heartwarming picture book for all ages explores questions about the intangible yet unbreakable connections between us, and opens up deeper conversations about love.

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Masking in autistic young people 

Masking is defined as the efforts made by individuals to minimise the appearance of differences. Similar to autism, masking lies on a spectrum, with great variation between autistic young people both in strategies used, and the extent to which they do mask. 

What does masking involve, why does it occur and what are the consequences?

For the autistic young people that are masking, research tells us that this can involve hiding emotions (happiness, sadness, anxiety), suppressing anything that might suggest they are different (sensory differences, motor difficulties, academic difficulties), copying or mimicking voices, and, in some cases, either suppressing or completely changing parts of their personality in order to present as ‘more’ neurotypical.  

Autistic young people may engage in masking as a response to negative social experiences, such as bullying, and the fear of being judged as different or strange, which in part may result from having a stigmatised diagnostic label. 

Autistic young people also report masking as a strategy to fit in and be ‘more’ neurotypical, something which may inadvertently be exacerbated by social skills interventions. Interventions that focus on improving specific social skills (e.g., eye contact) may indirectly perpetuate a harmful narrative which suggests that the way autistic young people communicate is not ‘correct’ and that they should change their communication style to ‘fit’ in, leading to further attempts to mask.  

While masking can lead to short-term success in social situations, it often results in exhaustion/ autistic burnout, identity loss, and has been linked with school avoidance as well as mental health issues such as depression and anxiety. In addition, due to hiding difficulties. those who mask a lot more are more likely to be missed or considered less needy of support by school and support services.

Do all autistic young people mask?

Research highlights that not all autistic young people engage in masking. For those that don’t, what appears to make the difference is having an absence of negative social experiences (e.g., bullying) and having supportive family, school environments and friends who provide them with instances (not always) where they can feel able to be themselves. In particular, research shows that the freedom for an autistic individual to be themselves, is more likely to occur when they have opportunities to interact with other neurodivergent individuals. 

So, what can you as a school do? 

Understanding & Support
Masking for autistic young people has an important function and is very often used for completely valid reasons. As parents and teachers, the goal should not be to remove or stop masking, but instead to understand its causes and try to support and target these (e.g., bullying, stigmatized label).

Social Networks
Positive social experiences and friendships appear to have a significant protective role. Therefore, schools should try to consider whether those who are masking have social networks, and in particular, neurodivergent networks, and if not, try to build these. This could involve setting up lunchtime clubs based on autistic young people’s interests or STEM clubs based on the same. Importantly involving autistic young people in the creation of these clubs may be key for their success. 

Language & Labels
Another driver of masking is a feeling of difference. This, in part, derives from being diagnosed with a label that frames symptoms in terms of dysfunction and impairment. Schools should, therefore, consider the language they use around autism and consider adopting a neurodivergent model where traits such as social communication difficulties are instead recognised as social communication differences.”

Praise
Be mindful of praising what appear to be social skills more in line with a neurotypical way of communicating. Instead focus on praising autistic young people’s bravery to share their experiences of being autistic in a neurotypical world and their openness and general efforts to communicate. 

Assess
Masking is a part of typical adolescent development, utilised by humans to navigate social situations and form positive impressions. It is, therefore, important to ensure that we consider the extent to which autistic young people are masking and whether or not this is severe, leading to harmful consequences.

LEANS Approach
Many autistic young people report experiences of bullying and victimisation, suggesting this is often a big reason for masking. Schools should, therefore, seek to improve other pupils’ understanding of and approach to difference. The LEANS approach is a free resource for teaching pupils about difference through a neurodiversity lens Learning About Neurodiversity at School (LEANS) | Salvesen Mindroom Research Centre (ed.ac.uk)

Self Understanding
It will be important to consider the extent to which any social skills interventions are inadvertently encouraging or emphasising ‘neurotypical’ ways of communicating. Instead of focusing on improving specific skills, social skills interventions should focus on supporting autistic young people to reflect on social situations and develop a deeper understanding of their own and others thoughts and feelings. 


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Supporting Cognitive Skills

Dynamic assessment (DA) is an area of EP work that is less known to schools but can be incredibly valuable in revealing ways that a child can learn best and the type of support/ mediation they would require to further develop their thinking skills and perform at their best. 

Dynamic assessment approaches (unlike static intelligence tests) are built on the belief that one can learn far more about a child’s cognitive development, and any barriers to their learning, by working with the child in a dynamic and facilitative way as opposed to assessing their unassisted performance and compare it to an age-related norm. Dynamic assessment approaches analyse learner’s cognitive skills of a learner in relation to the task at hand and identify where meaningful input is needed to optimise performance. 

There are ways school staff can use principles of dynamic assessment to scaffold learning. One basic element of DA is analysing where a learner’s struggle may be by breaking down the cognitive skills required in any given task into three areas:

INPUT
finding out what you need to do

  • Focused perception: using our senses (listen, smell, see, taste and touch) to get information
  • Systematic exploration: using a plan (system) so we do not miss or skip anything important
  • Labelling: Finding the names of objects and ideas
  • Find out where (spatial positions) and when (time, sequence and order)
  • Constancy: observing what stays the same when some things seem to change
  • Considering several sources of information: being able to use more than one idea at a time
  • Precision and accuracy: being careful when it matter

ELABORATION
processing information and problem solving

  • Defining the problem: knowing what we are asked to do 
  • Relevance: using only the information we need 
  • Interiorisation: holding a picture in our mind of what we must do 
  • Planning and sequencing the task: planning our steps
  • Working with several pieces of information: keep all the facts in mind 
  • Comparing: telling what is the same and what is different 
  • Categorisation: being able to put objects and ideas into groups based on their similarities and differences
  • Making links and relationships: finding out how things go together
  • Using concepts of space and time: finding where things belong and in what order
  • Developing hypothetical thinking and considering alternatives: thinking things out in our heads and then choosing.
  • Using logical reasoning: proving our ideas

OUTPUT
communicating the product of our thinking

  • Controlling impulsivity, reducing trial and error responses: thinking before we answer and do not rush
  • Reducing egocentric communication: expressing things clearly
  • Overcoming blocking: if we ‘know’ the answer but can’t express it right away, we wait and try again.

It is very common for children to appear unable to access a task because of difficulties in the input phase or because they have trouble presenting the product of their thinking. Analysing and supporting cognitive skills such as systematic planning, improving speed and accuracy as well as thinking about what is needed as the end product before launching into action, may be a very useful focus for school intervention / LSA support. There are ways to support these skills through every day activities and with good scaffolding questions such as:

“Where shall we start? What should we look at, first or second?”

“If you were to plan your trip to a supermarket, what system would you use? How can you do the same for this maths problem, piece of writing etc?” 

If you would like more ideas of how to support the development of cognitive skills (alongside curriculum support you are already providing), please do not hesitate to contact our service. We can offer dynamic assessment input for individual children as well as training for support staff in using DA principles in their every day practice. 

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Thinking about Autism and Girls

By Dr. Rose McGeown

Recent large-scale research has found that in the UK around 1 in 57 children are on the autistic spectrum, with around four boys being diagnosed for every one girl (4:1)[i]. Autism has long been thought to be much more prevalent in males than females, but new research suggests that the prevalence in females may be much higher than we previously thought[ii].

When considering the presentation of autism in girls and women, it is important to note that the key diagnostic criteria for autism remains true: Autism is a neurodevelopmental condition characterised by:

  1. Persistent difficulties in social communication and social interaction across multiple contexts
  2. Restricted, repetitive patterns of behaviour, interests or activities

However, what research is now telling us is that there are some key gender differences in the presentation of autism when comparing male and female individuals. Autistic females appear to present with more subtle difficulties and can appear more similar to their neurotypical peers[i]. This is leading to many girls having their needs inaccurately identified and missing out on timely support.

Difficulties with social communication and interaction

Research has shown that autistic girls have a greater need for social contact and interaction with peers[i],[ii]. They tend to form meaningful friendships and enjoy spending time with peers at social times in the school day. However, looking closer at these relationships may highlight some key challenges. For example, autistic girls are more likely to be on the periphery of social groups, may be more passive and struggle with initiating social interactions, have higher rates of conflict management and be more at risk of social isolation at school.

Research has also found that autistic girls are more likely to engage in ‘camouflaging’ behaviours, which enable them to present with superficial social skills and mask (or hide) their autistic differences[i]. This means that although many autistic girls may have learnt how to appear more sociable through observing and copying their peers, as social skills become more advantaged and nuanced, many autistic girls experience increased challenge due to their underlying social communication needs. The impact of this can be feelings of overwhelm, fatigue and emotional dysregulation, which are often internalised or only seen at home[ii].

Restricted, repetitive pattern of behaviour, interests or activities

Similarly, differences with restricted and repetitive patterns of behaviours, interests or activities can be much more subtle for autistic girls[i]. Autistic girls tend to have typical interests for their age e.g. animals, music, books, TV series, art and drama etc., but the intensity of this interest is atypical. For example, they may want to talk about their special interest for long periods of time, favour their special interest over social interaction or begin to identify as a character they are interested in. Repetitive patterns of behaviour, or ‘stimming’, whereby an individual engages in repetitive movements to regulate themselves may also be more subtle in girls e.g. twirling their hair, shaking their leg, playing with a piece of blue tac in class, meaning that for teachers to notice that this child is feeling dysregulated is tricky.

How staff can support autistic female pupils at school

  • Be aware of gender differences in autism and look out for more subtle social communication differences in girls
  • Provide timely support for autistic female pupils in school
  • Provide explicit teaching of social skills and conflict management skills
  • Engage pupil’s special interests for motivation
  • Support emotional regulation throughout the school day
  • Support sensory differences within the school environment
  • Display positive female autistic role models in school
  • Maintain good communication between home and school
  • Discuss individual pupils who you are concerned about with your link Educational Psychologist

References

i Roman-Urrestarazu, A., van Kessel, R., Allison, C., Matthews, F. E., Brayne, C., & Baron-Cohen, S. (2021). Association of race/ethnicity and social disadvantage with autism prevalence in 7 million school children in England. JAMA pediatrics, 175(6), e210054-e210054.

ii Loomes R, Hull L, Mandy WPL. (2017) What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis. J Am Acad Child Adolesc Psychiatry.

iii Russell, G., Steer, C., & Golding, J. (2011). Social and demographic factors that influence the diagnosis of autistic spectrum disorders. Social Psychiatry and Psychiatric Epidemiology, 46(12), 1283–1293.

iv Cridland, E. K., Jones, S. C., Caputi, P., & Magee, C. A. (2014). Being a girl in a boys’ world: Investigating the experiences of girls with autism spectrum disorders during adolescence. Journal of autism and developmental disorders, 44(6), 1261-1274

v Sedgewick, F., Hill, V., Yates, R., Pickering, L., & Pellicano, E. (2016). Gender differences in the social motivation and friendship experiences of autistic and non-autistic adolescents. Journal of autism and developmental disorders, 46(4), 1297-1306.

vi Allely, C. S. (2019). The female phenotype of autism spectrum disorder: The ‘camouflage’hypothesis. Editorial Board Members.

vii Baldwin, S., & Costley, D. (2016). The experiences and needs of female adults with high-functioning autism spectrum disorder. Autism, 20(4), 483-495.

viii Sutherland, R., Hodge, A., Bruck, S., Costley, D., & Klieve, H. (2017). Parent-reported differences between school-aged girls and boys on the autism spectrum. Autism, 21(6), 785-794.

Categories
resource

 The importance of father inclusion in schools

Fathers have an impact upon the child’s cognitive, emotional, social and physical development (Allen & Daly, 2002).

Kim and Hill (2015) found in a meta-analysis of studies found that despite mothers having higher mean levels of involvement in their child’s education,fathers also equally showed a strong positive association for their involvement and their child’s academic achievements.

Fathers who are nurturing in their roles tend to have children with higher cognitive and receptive languagescores(Dubowitz et al., 2002) and fewer behavioural needs (Cooley & Unger, 1991).

 Jeynes (2015) found that across 66 studies, father involvement often yielded the largest effect sizes regarding positive outcomes for children of minority ethnic backgrounds. 

Inclusive practice for fathers in schools:

Child Protection
Ensure you are mindful of fathers’ rights when engaging in safeguarding issues. For example, consider what are the legal rights of fathers who may not live in the same home as their child? Do they retain parental responsibility? What are the legal parental arrangements?

Father Inclusive Schools
Foster an environment that acknowledges different types of family structures e.g., single fathers, same sex parents, fathers who are the main care-giver.

Contact 
Ensure fathers are included in all correspondence e.g., emails, letters and meetings, reports and exam results. Include fathers contact details in referral forms to outside agencies. 

Representation & Inclusion
Some research (Fetcheriet al. 2011)suggested that fathers are more likely to become involved in school activities if the facilitator is male. Are there ways in which we can be mindful of the gender ratio of staff and how we can include fathers to support school activities? What are the fathers’ skill set and how can you work collaboratively?

Accessibility
Allow for flexibility in meetings e.g., making use of online or hybrid models and adjusting timing to ensure fathers and working parents can attend. Use an interpreter for families where a father may have English as an Additional Language (EAL). Be mindful that fathers from other cultures may have different experiences of school engagement and may not be familiar with school systems. Continue to identify other barriers to involvement fathers may experience.

Other Resources

SOMETHING TO READ:
Father Friendly Schools -Fathers Network Scotland
www.fathersnetwork.org.uk

SOMETHING TO CONNECT WITH: www.fatherhoodinstitute.org

SOMETHING TO ENJOY: 
Fatherhood by Kevin Hart –Netflix